Effect Measure is a forum for progressive public health discussion and argument as well as a source of public health information from around the web that interests the Editor(s)

Friday, October 14, 2005

The message is the message

Interesting news that the results from testing the H5 Romanian bird flu virus, expected today, will be "delayed" until tomorrow, according to the European Commission. The reason given was difficulties with customs “which come into play for the transport of ’dangerous material’.”

Possibly true (although it sounds a bit sketchy). Also possible that the EC is trying to (pardon the expression) "get all its ducks in a row" before making an announcement. There has been continual concern (although not much competence) in "information management" at the EC, WHO, CDC and almost every other governmental body. Understandable, perhaps. But it doesn't encourage trust or confidence.

WHO is treading the fine line between expressing urgency and trying to tamp down the consequences of sounding an alarm. Sometimes they do it well. Sometimes poorly. Sometimes they do both, almost at the same time:

The spread of the deadly bird flu virus to poultry in new areas on the fringes of Europe has increased the chances of human cases, but "false alarms" are also likely, the World Health Organization (WHO) said on Friday.

The United Nations agency called for tighter surveillance of both flocks and humans to quickly detect any further outbreaks after avian viruses were identified in Turkey and Romania.

But in a statement, it said all evidence indicated that the highly pathogenic H5N1 virus still does not spread easily from birds to infect humans. (Reuters)

The first sentence is true and appropriate. The second good policy. The third, possibly false (considering some evidence from Indonesia) and seems addressed to public concerns. It is likely to decrease trust, not increase usable information. How is a person to know what they should or should not do and what hte risk is? Consider the following report from Associated Press (via myTelus):

Turkish officials put nine people under medical observation after reports that 40 pigeons in their neighbourhood mysteriously died, as officials confirmed that earlier bird deaths were caused by a virulent strain of bird flu, authorities said Friday.

In Kiziksa, where the earlier deaths occurred, veterinary officials in protective suits were culling the few remaining birds in the village. Officials already have culled some 8,600 birds in the western Turkish village and vowed to kill all within a three kilometre radius surrounding Kiziksa as a precaution against the spread of the highly contagious H5N1 strain of the avian flu.

So it is hard to get infected by birds, nine people are under observations because pigeons in their neighborhood have mysteriously died, and veterinary officials are wearing protective suits. What are people supposed to make of this kind of information?

It wouldn't take much extra effort to think through the message a bit more carefully.